NCG060205_DMR_20220629

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG066 2 0 SAMPLE COLLECTION YEAR �_)b FACILITY NAME Cus•t-., �;�:s(.•,-5 �N c SAMPLE PERIOD [R Jan-June ❑July-Dec
COUNTY VwA or El Monthly' (month)
PERSON COLLECTING SAMPLES v;..C3 �y��0s1�:
LABORATORY Qact Lobs Lab Cert.# I DISCHARGING'TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero-flow ❑Water Supply ❑SA
❑Other 4,,0 u- nJ C
RECFN rl FACILITY ACTIVITIES INCLUDE(check all that apply):
JUL 112022 ❑ use/process meats ❑use animal fats/byproducts
CENTRAL FIDES
DWR SEC1"IM1 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A:Stormwater Benchmarks and Monitoring Results Total event rainfall' or [�(N o discharge this period'
!'° Date Sample w °TSS, 7._ pH, COD, Oil andsGrease, ,Fecal Coliform,', Enterococci,
Outfall No �Collectetl`mo/dd/yr m /l =_° . _1 ��°" Stanbard units- m L _� La ° Colonies `er'g = g/ r,_° mg/ p QOO.mI �_Colon�es,per 10ff_ml
Benchmark - 100 or 50" Within 6 0=9 0 120 30' 're'10001 5001 }
Parameter CodeC0530 00400,. 3 , 00340; 00556 31616 61211"'>
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls.You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text,Table 1,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling(instead of semi-annual)must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month?❑yes [0"no (if yes' complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249,Last Revised 11/5/2018
Page 1 of 2

i
)
Part B:Vehicle Maintenance Area Monitoring Results:only for facilities
sag
da
|
/
/
|
Fomnm�sf�mPmrt�m��a���tpPm�0 �
^ |
*FOR PART 0kAND PART B MONITORING RESULTS: '
w A BENCHMARK EXCEEDANCE TRIGGERS TIER 1REQUIREMENTS. SEE PERMIT PART||SECTION B.
* 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2REQuIRE&8ENTS. SEE PERMIT PART||SECTION 8 .
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 8 | NO��
|F YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES �� NO��
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR,including all"'No Discharge"reports, within 30 days of receipt of the lab results for at end of rnonitoriw period in the case
of"'No Discharge"reports)to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
'
`
/
`
`
�
"I certify, under penalty oflaw,that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified person nel.properly gather and evaluate the information submitted. Based onmy inquiry of the person or persons who
manage the system, or those persons directlyresponsible for gathering the information,the'information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information, including the possibility offinesand
^^rri---- '
Signature of Permittee
Permit Date: Il/l/ZO18'U5/]I/2OZ1 3VVU-249 Last Revised 11/S/ZO18